A Case of Metabolic Encephalopathy Triggered by Food Supplements
Bibliographic record
Abstract
A 59-year-old Caucasian female with history of multiple sclerosis (MS), osteoporosis and breast cancer presented with weakness, constipation, confusion and short term memory loss. Her metabolic profile showed pre renal azotemia and severe hypercalcemia (16.2 mg%). Aggressive medical management led to favorable resolution of her symptoms. A complete diagnostic work up for the etiology of hypercalcemia was then performed. PTH levels were suppressed at 5.6 pg / mL arousing suspicion for hypercalcemia due to malignancy (prior history of breast cancer vs. new primary). PTHrP (0.8 pmol / L), TSH (0.623 IU / L) and free T4 (2.87 ng / dL) were within normal limits. 25- hydroxy Vitamin D level was high at 96 ng / mL, while 1-25 dihydroxy vitamin D was 28 pg / mL. Review of her medication list showed daily intake of 800 units of vitamin D. The patient denied overdosing on prescription vitamin D but later admitted that she was ingesting an expensive naturally derived gel preparation containing about 16,000 IU of vitamin D3 daily. This was one of several alternative medications prescribed to her by an online practitioner for her MS and osteoporosis. Patient was counseled on potential side effects of excessive vitamin D supplementation and these were withheld at the time of discharge. J Endocrinol Metab. 2013;3(1-2):38-40 doi: https://doi.org/10.4021/jem146w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.004 | 0.002 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.005 | 0.005 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".